利培酮、奥氮平、喹硫平对首发精神分裂症患者认知功能和社会功能的影响

目的 比较利培酮、奥氮平、喹硫平对首发精神分裂症患者认知功能和社会功能的影响.方法 对61例确诊为首发精神分裂症的患者进行为期6周的研究,评定认知功能和评定社会功能及疗效评定,并以42名健康人群进行对照.结果 利培酮组、奥氮平组和喹硫平,平均日剂量分别为4.2mg、18.6mg、561.3 mg.从基线至6周实验结束,治疗组阳性与阴性症状量表(PANSS)减分值分别为(19.7±20.2)分、(20.2±21.0)分、(15.8±19.4)分,个人和社会功能量表(PSP)评分改变为(7.8±16.3)分、(8.2±15.2)分、(6.8±14.8)分.临床病情严重程度量表(CGI-S)评定在3个治疗组从基线到终点的改善显著(P<0.05).所有患者组治疗前各项认知功能指标评分与正常组比较差异存在显著性(P<0.05).治疗后利培酮组和喹硫平组在执行功能、记忆均未见改善,奥氮平组在威斯康星卡片分类测验(WCST)三项指标中有改善(P<0.05).3个治疗组在知觉运动速率以及注意、概念转换能力有改善(P<0.05).利培酮组最常见的不良事件为轻度的EPS,奥氮平、喹硫平组发生率最高的不良事件是嗜睡.结论 利培酮、奥氮平、喹硫平都能改善首发精神分裂症患者的部分认知功能及社会功能,作用相当.

Influence of three antipsychotics on cognitive function and social functioning in patients with first-episode schizophrenia

Objective To compare the influence of risperidone,olanzapine and quetiapine on cognitive function and social functioning in patients with first-episode schizophrenia. Methods Total of 61 patients diag-nosed with first-episode schizophrenia were evaluated on efficacy, social functioning and cognitive function in 6 weeks,and 42 healthy controls were given a same cognitive function assessment. Results Mean doses were 4.2 mg/d, 18.6 mg/d,and 561.3 mg/d for risperidone,olanzapine,and quetiapine respectively. The mean change from baseline to end point in PANSS and PSP total score in three groups were 19.7±20.2,20.2±21.0,15.8±19.4 and 7.8±16.3,8.2±15.2,6.8±14.8 respectively. Significant improvements from baseline to end point were observed on the CGI-S scale in the three treatment groups (P<0.05). All the patients before treatment compare with normal controled group in cognitive function measurement such as WCST,TMT and WMS,were sig-nificant differences (P<0.05). Executive function and memory after treatment had not improved in risperidone and quetiapine group, while three indices of WCST has improved in olanzapine group (P<0.05) ,rate of motion percep-tion,attention and capacity of concept conversion had be improved in all groups (P<0.05). The most frequently adverse events reported in Risperidone group was EPS which were mild in severity,in olanzapine and quetiapine group,the most frequently adverse events were somnolence. Conclusion Risperidone,olanzapine and quetiapine can improve part of cognitive function and social functioning in patients with first-episode schizophrenia, and the effects of them were similar.